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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu
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s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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The Country Cooperation Strategy is the World Health Organization (WHO)’s reference for country work guiding planning and resource allocation through alignment with national health priorities and harmonization with other development partners. It clarifies roles and functions of WHO in supporting t
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he national strategic plan for health through the Sector-Wide Approach and Malawi Growth and Development Strategy II. The Country Cooperation Strategy is based on a systematic assessment of the recent national achievements, emerging health needs,
challenges, government policies and expectations. An evaluation of the previous CCS was conducted and jointly discussed with the Ministry of Health as well as other key stakeholders. This process led to the identification of the, achievements, challenges and shortfalls of the previous CCS. Through this process the areas where WHO needed to focus on were also identified. The CCS development has also been done in parallel with the formulation of the new Health Sector Strategic Plan (HSSP) to ensure that there is a linkage between the two.
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Health communication has proven to play a crucial role in addressing diseases such as dengue, Zika and chikungunya, for which there are no definitive or easily accessible vaccines. In this context, this discipline becomes a fundamental tool to promote the change behavior and promote preventive pract
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ices that reduce the transmission of these diseases. By not having a definitive medical solution, accurate and timely information, effectively disseminated through educational campaigns, media and communication channels public health, can significantly influence individual and community actions to control the spread of these mosquito-borne viruses. The accumulated research around the threat of the aforementioned arboviral diseases brings together a series of recommendations around specific communication activities, such as disseminating timely and accurate information that integrates public health concerns and the needs of information of the population, especially vulnerable groups such as women of childbearing age, pregnant women and health workers.
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In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financialization in the
health domain could be described as the uncontrolled expansion of finance along vari
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ous lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
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This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within
health financing, and
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overall system, reform design and implementation processes. This Guide is complementary to WHO’s Health Financing Progress Matrix assessment, as well as Health Financing Strategy development guidance. In this way, it promotes an embedded political
economy analysis approach that can be used in conjunction with other health financing assessments and guidance. The political economy framework can also be extended and easily adapted to broader health policy reforms.
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These guidelines have been developed in simple, user-friendly language and they explain the procedures for patients’ access to and the safe management of Schedule I and II drugs that are necessary for the treatment and relief of moderate to severe pain. They provide both procedures for acquisition
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and information on records or documents that are necessary to ensure that these medicines are made available and accessible to patients across the entire health care delivery system (i.e. from tertiary institutions to primary level) and ensuring prevention of illicit non-medical use.
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The standards of care for HIV define the expected or desired quality of prevention, treatment, and care for people at risk of HIV acquisition or living with HIV.
The standards are based on a scientific rationale, as well as the responsibilities of each stakeholder, to ensure that people receive app
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ropriate, high-quality prevention and care that aligns with the most up-to-date medical knowledge and ethical standards
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In: Antenatal Care, Maternal Care, Under 5 Clinics, Family Planning Clinics and HIV Exposed Child Follow Up.
This 5th Edition of the Malawi Guidelines for Clinical Management of HIV in Children and Adults is implemented from January 2022. It replaces all previous editions of the Malawi Antiretrovir
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al therapy (ART) and Prevention of Mother to Child Transmission (PMTCT) guidelines.This document is written for medical doctors, clinical officers, medical assistants, nurses, midwives, laboratorians, health surveillance assistants (HSAs) and medical records clerks who are working in public and private sector health facilities in Malawi. It is designed to be a practical guide for implementation of integrated HIV Services
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This training seeks to equip health workers who have contact with children in HIV settings with the knowledge and skills to better integrate violence against children (VAC) services into their work. It seeks to transmit information and skills to make them: feel comfortable talking with, providing se
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rvices and making appropriate referrals to children and their caregivers who are at risk of or experiencing violence.
This three-day training package includes ten modules to be delivered to groups of 25-30 health workers. The training is aimed at different cadres of health workers, including: nurses and midwives; clinicians; HIV counselors; medical social workers; pharmacists; community health workers, and others who are involved in children’s health care in health settings
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The WHO publication “Surveillance, case investigation and contact tracing for mpox: interim guidance” provides updated global technical guidance on monitoring and responding to mpox (formerly known as monkeypox). It explains how countries should conduct surveillance to detect new outbreaks, car
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ry out case investigation including clinical assessment and lab specimen collection, and perform contact tracing to monitor people exposed to confirmed or probable cases in order to stop transmission and protect at-risk groups. The guidance includes practical recommendations for how long contacts should be monitored (e.g., daily for 21 days without requiring quarantine if symptom-free) and advising good hygiene and reduced exposure risk during the monitoring period. This interim guidance is intended to support public health authorities worldwide in strengthening mpox outbreak detection, response, and reporting.
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Guide to revision of national pandemic influenza preparedness plans - Lessons learned from the 2009 A(H1N1) pandemic
Brown C., Ciotti M., Hegermann-Lindencrone M., et al
European Centre for Disease Prevention and Control (ECDC), WHO Regional Office for Europe
(2017)
C_WHO
The document “Guide to revision of national pandemic influenza preparedness plans – Lessons learned from the 2009 A(H1N1) pandemic” provides guidance for countries on how to improve and update their national pandemic preparedness plans. It is based on lessons learned from the 2009 influenza pa
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ndemic and aims to help governments strengthen their readiness for future pandemics. The report outlines key components of effective pandemic planning, including risk assessment, coordination between sectors, communication strategies, healthcare system preparedness, vaccination and antiviral strategies, and business continuity planning. It also emphasizes the importance of international cooperation and flexible planning that can adapt to different pandemic scenarios. Overall, the guide serves as a framework to support countries in developing stronger, more coordinated responses to future influenza pandemics.
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The document “Strengthening the global architecture for health emergency prevention, preparedness, response and resilience” presents a report by the Director-General of the World Health Organization (WHO) to the World Health Assembly on global efforts to improve preparedness and response to heal
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th emergencies. It reviews the implementation of the Health Emergency Prevention, Preparedness, Response and Resilience (HEPR) framework and highlights lessons learned from recent crises such as COVID-19. The report describes international initiatives to strengthen global health governance, surveillance systems, laboratory networks, community protection measures, healthcare capacity and access to medical countermeasures like vaccines and diagnostics. It also discusses coordination of emergency responses, support for countries facing outbreaks or humanitarian crises, and the importance of international cooperation. In addition, the report emphasizes the need for sustainable and coordinated financing to strengthen global health security and ensure that countries can better prevent, detect and respond to future health threats.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel
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erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea
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lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base
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d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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The document provides a standardized protocol for evaluating the Early Warning Alert and Response Network (EWARN), a surveillance system used during humanitarian emergencies when regular national health surveillance may be disrupted. The purpose of EWARN is to detect outbreaks of communicable diseas
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es early and enable rapid public health response. The guidance explains how the system should be assessed in terms of its structure, implementation, effectiveness, and usefulness. It outlines the key steps of evaluation: preparation, system description, data collection, and post-evaluation reporting. The protocol highlights common challenges observed in previous EWARN implementations, such as delays in establishing the system, limited data quality, weak outbreak response, and lack of clear transition plans back to routine surveillance systems. It emphasizes the need to evaluate both weekly disease reporting and alert verification processes, and to review attributes such as simplicity, data quality, timeliness, sensitivity, and stability. The document also provides templates for interviews, data review forms, and laboratory assessment, as well as guidance on conducting remote evaluations when access is limited. The overall goal of the protocol is to ensure that EWARN functions effectively to detect and respond to outbreaks and that practical recommendations are developed to improve the system’s performance and sustainability in emergency settings.
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CGA Toolkit Plus
recommended
(2019)
CC
Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
Accessed October 30, 2019
CHEMM Intelligent Syndromes Tool (CHEMM-IST) is an online decision support system for hazardous materials incidents assessing the possibility of 7 syndromes based on questions about the patients physical state. Includes quick links to medical guide
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lines.
ext. Homepage, accessed 29/03/2018
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Position statement for adult and paediatric spirometry in South Africa: 2022 update
Maree, D.M.; Swanepoel, R.A.; Swart, F. et al.
African Journal of Thoracic and Critical Care Medicine
(2022)
CC
Spirometry is required as part of the comprehensive evaluation of both adult and paediatric individuals with suspected or confirmed respiratory diseases and occupational assessments. It is used in the categorisation of impairment, grading of severity, asse
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ssment of potential progression and response to interventions. Guidelines for spirometry in South Africa are required to improve the quality, standardisation and usefulness in local respiratory practice. The broad principles of spirometry have remained largely unchanged from previous versions of the South African Spirometry Guidelines; however, minor adjustments have been incorporated from more comprehensive international guidelines, including adoption of the Global Lung Function Initiative 2012 (GLI 2012) spirometry reference equations for the South African population.
All equipment should have proof of validation regarding resolution and consistency of the system. Daily calibration must be performed, and equipment quality control processes adhered to. It is important to have standard operating procedures to ensure consistency and quality and, additionally, strict infection control as highlighted during the COVID-19 pandemic.
Adequate spirometry relies on a competent, trained operator, accurate equipment, standardised operating procedures, quality control and patient co-operation. All manoeuvres must be performed strictly according to guidelines, and strict quality assurance methods should be in place, including acceptability criteria (for any given effort) and repeatability (between efforts).
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Research in Brief.
The international community’s predominant response to the Venezuelan migration crisis remains focused on humanitarian relief. This is important, for two populations: a) the over 50,000 ‘pendular’ migrants who go back and forth across the border every day in order to access
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food and basic services; b) those who seek residency in Colombia or another country, and require immediate support in terms of food, shelter, and medical access. However, Betts states, for the over 1.2 million migrants who have settled in Colombia, a longer-term vision is needed, which must be based on seeing Venezuelan migration as a development opportunity that can benefit both migrants and citizens
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